Doença pulmonar obstrutiva crônica e fatores associados em São Paulo, SP, 2008-2009

OBJETIVO: Estimar a prevalência e fatores associados à doença pulmonar obstrutiva crônica. MÉTODOS: Estudo transversal, de base populacional com 1.441 indivíduos de ambos os sexos e com 40 anos de idade ou mais no município de São Paulo, SP, entre 2008 e 2009. As informações foram coletadas por meio de entrevistas domiciliares e os participantes foram selecionados a partir de amostragem probabilística, estratificada por sexo e idade, e por conglomerados em dois estágios (setores censitários e domicílios). Foi realizada regressão múltipla de Poisson na análise ajustada. RESULTADOS: Dos entrevistados, 4,2% (IC95% 3,1;5,4) referiram doença pulmonar obstrutiva crônica. Após análise ajustada, identificaram-se os seguintes fatores independentemente associados ao agravo: número de cigarros fumados na vida (> 1.500/nenhum) RP = 3,85 (IC95%: 1,87;7,94), cansar-se com facilidade (sim/não) RP = 2,61 (IC95% 1,39;4,90), idade (60 a 69 anos/50 a 59 anos) RP = 3,27 (IC95% 1,01;11,24), idade (70 anos e mais/50 a 59 anos) RP = 4,29 (IC95% 1,30;14,29), problemas de saúde nos últimos 15 dias (sim/não) RP = 1,31 (IC95% 1,02;1,77), e atividade física no tempo livre (sim/não) RP = 0,57 (IC95% 0,26;0,97). CONCLUSÕES: A prevalência da doença pulmonar obstrutiva crônica é elevada e está associada ao uso do tabaco e idade acima de 60 anos. Os problemas de saúde freqüentes e redução da atividade física no tempo livre podem ser considerados conseqüências dessa doença.

Fatores de risco e proteção para doenças crônicas não transmissíveis entre beneficiários da saúde suplementar: resultados do inquérito telefônico Vigitel, Brasil, 2008

O objetivo deste artigo é descrever a distribuição dos principais fatores de risco (FR) e proteção para doenças crônicas não transmissíveis (DCNT) entre os beneficiários de planos de saúde. Foi utilizada amostra aleatória de adultos com 18 ou mais anos de idade nas capitais brasileiras, analisando-se frequências de FR em 28.640 indivíduos em 2008. Homens mostraram alta prevalência dos seguintes fatores de risco: tabaco, sobrepeso, baixo consumo de frutas e legumes, maior consumo de carnes gordurosas e álcool, enquanto mulheres mostraram maior prevalência de pressão arterial, diabetes, dislipidemia e osteoporose. Homens praticam mais atividade física e mulheres consomem mais frutas e vegetais. Homens com maior escolaridade apresentam maior frequência de sobrepeso, consumo de carnes com gorduras e dislipidemia. Entre mulheres, tabaco, sobrepeso, obesidade e doenças autorreferidas decrescem com aumento da escolaridade, enquanto o consumo de frutas e legumes, atividade física, mamografia e exame de papanicolau aumentam com a escolaridade. CONCLUSÃO: a população usuária de planos de saúde constitui cerca de 26% da população brasileira, e o estudo atual visa acumular evidências para atuação em ações de promoção da saúde para esse público.

Lei n.º 11.889/2008: avanço ou retrocesso nas competências do técnico em saúde bucal?

O objetivo deste estudo foi analisar as competências que, desde a aprovação da lei n.º 11.889/08, incumbem ao técnico em saúde bucal (TSB) no Brasil, incluindo os termos definidos para sua supervisão. Foi realizada análise documental, comparando-se as competências definidas no referido instrumento legal com as previstas no parecer n.º 460/75 do Conselho Federal de Educação e na resolução n.º 63/2005 do Conselho Federal de Odontologia. Foram empregadas técnicas de análise temática considerando-se as habilidades em termos de ações diretas e indiretas distribuídas em quatro áreas de competência: planejamento e administração em saúde, promoção da saúde, prevenção de doenças e de assistência individual. Embora as competências aprovadas na lei tenham sido distribuídas em um número menor de itens, comparado aos dois outros documentos, do ponto de vista qualitativo, os resultados da análise permitiram concluir que vários avanços foram obtidos com a regulamentação da profissão, nos termos aprovados, em todas as áreas de competência. Houve impacto positivo para o processo de trabalho em saúde, tanto com relação à cooperação interprofissional quanto à supervisão técnica das atividades, representando uma conquista relevante dos trabalhadores da área e também uma contribuição significativa para avançar na ampliação do acesso aos serviços odontológicos

Highlights from the I international symposium of thrombosis and anticoagulation in internal medicine, October 23–25, 2008, Sao Paulo, Brazil

Abstract The importance of thrombosis and anticoagulation in clinical practice is rooted firmly in several fundamental constructs that can be applied both broadly and globally. Awareness and the appropriate use of anticoagulant therapy remain the keys to prevention and treatment. However, to assure maximal efficacy and safety, the clinician must, according to the available evidence, choose the right drug, at the right dose, for the right patient, under the right indication, and for the right duration of time. The first International Symposium of Thrombosis and Anticoagulation in Internal Medicine was a scientific program developed by clinicians for clinicians. The primary objective of the meeting was to educate, motivate and inspire internists, cardiologists and hematologists by convening national and international visionaries, thought-leaders and dedicated clinician-scientists in Sao Paulo, Brazil. This article is a focused summary of the symposium proceedings

Yellow Fever Virus in Haemagogus leucocelaenus and Aedes serratus Mosquitoes, Southern Brazil, 2008

Yellow fever virus (YFV) was isolated from Haemagogus leucocelaenus mosquitoes during an epizootic in 2001 in the Rio Grande do Sul State in southern Brazil In October 2008 a yellow fever outbreak was reported there with nonhuman primate deaths and human cases This latter outbreak led to intensification of surveillance measures for early detection of YFV and support for vaccination programs We report entomologic surveillance in 2 municipalities that recorded nonhuman primate deaths Mosquitoes were collected at ground level identified and processed for virus isolation and molecular analyses Eight YFV strains were isolated (7 from pools of Hg leucocelaenus mosquitoes and another from Aedes serratus mosquitoes) 6 were sequenced and they grouped in the YFV South American genotype I The results confirmed the role of Hg leucocelaenus mosquitoes as the main YFV vector in southern Brazil and suggest that Ae serratus mosquitoes may have a potential role as a secondary vector

The peculiar nova V1309 Scorpii/nova Scorpii 2008 A candidate twin of V838 Monocerotis

Aims. Nova Scorpii 2008 was the target of our Director Discretionary Time proposal at VLT+UVES in order to study the evolution, origin and abundances of the heavy-element absorption system recently discovered in 80% of classical novae in outburst. Methods. The early decline of nova Scorpii 2008 was monitored with high resolution echelle spectroscopy at 5 different epochs. The analysis of the absorption and the emission lines show many unusual characteristics. Results. Nova Scorpii 2008 is confirmed to differ from a common classical nova as well as a symbiotic recurrent nova, and it shows characteristics which are common to the so called, yet debated, red-novae. The origin of this new nova remains uncertain.

An overview of the Amazonian Aerosol Characterization Experiment 2008 (AMAZE-08)

The Amazon Basin provides an excellent environment for studying the sources, transformations, and properties of natural aerosol particles and the resulting links between biological processes and climate. With this framework in mind, the Amazonian Aerosol Characterization Experiment (AMAZE-08), carried out from 7 February to 14 March 2008 during the wet season in the central Amazon Basin, sought to understand the formation, transformations, and cloud-forming properties of fine-and coarse-mode biogenic aerosol particles, especially as related to their effects on cloud activation and regional climate. Special foci included (1) the production mechanisms of secondary organic components at a pristine continental site, including the factors regulating their temporal variability, and (2) predicting and understanding the cloud-forming properties of biogenic particles at such a site. In this overview paper, the field site and the instrumentation employed during the campaign are introduced. Observations and findings are reported, including the large-scale context for the campaign, especially as provided by satellite observations. New findings presented include: (i) a particle number-diameter distribution from 10 nm to 10 mu m that is representative of the pristine tropical rain forest and recommended for model use; (ii) the absence of substantial quantities of primary biological particles in the submicron mode as evidenced by mass spectral characterization; (iii) the large-scale production of secondary organic material; (iv) insights into the chemical and physical properties of the particles as revealed by thermodenuder-induced changes in the particle number-diameter distributions and mass spectra; and (v) comparisons of ground-based predictions and satellite-based observations of hydrometeor phase in clouds. A main finding of AMAZE-08 is the dominance of secondary organic material as particle components. The results presented here provide mechanistic insight and quantitative parameters that can serve to increase the accuracy of models of the formation, transformations, and cloud-forming properties of biogenic natural aerosol particles, especially as related to their effects on cloud activation and regional climate.

Design of concrete-filled steel tubular columns under axial loading according to NBR 8800:2008 and Eurocode 4:2004: tests results and comparisons

In this paper results of tests on 32 concrete-filled steel tubular columns under axial load are reported. The test parameters were the concrete compressive strength, the column slenderness (L/D) and the wall thickness (t). The test results were compared with predictions from the codes NBR 8800:2008 and EN 1994-1-1:2004 (EC4). The columns were 3, 5, 7 and 10 length to diameter ratios (L/D) and were tested with 30MPa, 60MPa, 80MPa and 100MPa concrete compressive strengths. The results of ultimate strength predicted by codes showed good agreement with experimental results. The results of NBR 8800 code were the most conservative and the EC4 showed the best results, in mean, but it was not conservative for usual concrete-filled short columns.

The 2008 update of the Aspergillus nidulans genome annotation: A community effort

The identification and annotation of protein-coding genes is one of the primary goals of whole-genome sequencing projects, and the accuracy of predicting the primary protein products of gene expression is vital to the interpretation of the available data and the design of downstream functional applications. Nevertheless, the comprehensive annotation of eukaryotic genomes remains a considerable challenge. Many genomes submitted to public databases, including those of major model organisms, contain significant numbers of wrong and incomplete gene predictions. We present a community-based reannotation of the Aspergillus nidulans genome with the primary goal of increasing the number and quality of protein functional assignments through the careful review of experts in the field of fungal biology. (C) 2009 Elsevier Inc. All rights reserved.

EULAR/PRINTO/PRES criteria for Henoch-Schonlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteria

Objectives To validate the previously proposed classification criteria for Henoch-Schonlein purpura (HSP), childhood polyarteritis nodosa (c-PAN), c-Wegener granulomatosis (c-WG) and c-Takayasu arteritis (c-TA). Methods Step 1: retrospective/prospective webdata collection for children with HSP, c-PAN, c-WG and c-TA with age at diagnosis <= 18 years. Step 2: blinded classification by consensus panel of a representative sample of 280 cases. Step 3: statistical (sensitivity, specificity, area under the curve and.-agreement) and nominal group technique consensus evaluations. Results 827 patients with HSP, 150 with c-PAN, 60 with c-WG, 87 with c-TA and 52 with c-other were compared with each other. A patient was classified as HSP in the presence of purpura or petechiae (mandatory) with lower limb predominance plus one of four criteria: (1) abdominal pain; (2) histopathology (IgA); (3) arthritis or arthralgia; (4) renal involvement. Classification of c-PAN required a systemic inflammatory disease with evidence of necrotising vasculitis OR angiographic abnormalities of medium-/small-sized arteries (mandatory criterion) plus one of five criteria: (1) skin involvement; (2) myalgia/muscle tenderness; (3) hypertension; (4) peripheral neuropathy; (5) renal involvement. Classification of c-WG required three of six criteria: (1) histopathological evidence of granulomatous inflammation; (2) upper airway involvement; (3) laryngo-tracheo-bronchial involvement; (4) pulmonary involvement (x-ray/CT); (5) antineutrophilic cytoplasmic antibody positivity; (6) renal involvement. Classification of c-TA required typical angiographic abnormalities of the aorta or its main branches and pulmonary arteries (mandatory criterion) plus one of five criteria: (1) pulse deficit or claudication; (2) blood pressure discrepancy in any limb; (3) bruits; (4) hypertension; (5) elevated acute phase reactant. Conclusion European League Against Rheumatism/Paediatric Rheumatology International Trials Organisation/Paediatric Rheumatology European Society propose validated classification criteria for HSP, c-PAN, c-WG and c-TA with high sensitivity/specificity.

Chronic obstructive pulmonary disease in Brazil: mortality and hospitalization trends and rates, 1996-2008

SETTING: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death among adults in Brazil. OBJECTIVE: To evaluate the mortality and hospitalisation trends in Brazil caused by COPD during the period 1996-2008. DESIGN: We used the health official statistics system to obtain data about mortality (1996-2008) and morbidity (1998-2008) due to COPD and all respiratory diseases (tuberculosis: codes A15-16; lung cancer: code C34, and all diseases coded from J40 to 47 in the 10th Revision of the International Classification of Diseases) as the underlying cause, in persons aged 45-74 years. We used the Joinpoint Regression Program log-linear model using Poisson regression that creates a Monte Carlo permutation test to identify points where trend lines change significantly in magnitude/direction to verify peaks and trends. RESULTS: The annual per cent change in age-adjusted death rates due to COPD declined by 2.7% in men (95%CI -3.6 to -1.8) and -2.0% (95%CI -2.9 to -1.0) in women; and due to all respiratory causes it declined by -1.7% (95%CI 2.4 to -1.0) in men and -1.1% (95%CI -1.8 to -0.3) in women. Although hospitalisation rates for COPD are declining, the hospital admission fatality rate increased in both sexes. CONCLUSION: COPD is still a leading cause of mortality in Brazil despite the observed decline in the mortality/hospitalisation rates for both sexes.

Demographic profile of blood donors at three major Brazilian blood centers: results from the International REDS-II study, 2007 to 2008

BACKGROUND: The profile of blood donors changed dramatically in Brazil over the past 20 years, from remunerated to nonremunerated and then from replacement to community donors. Donor demographic data from three major blood centers establish current donation profiles in Brazil, serving as baseline for future analyses and tracking longitudinal changes in donor characteristics. STUDY DESIGN AND METHODS: Data were extracted from the blood center, compiled in a data warehouse, and analyzed. Population data were obtained from the Brazilian census. RESULTS: During 2007 to 2008, there were 615,379 blood donations from 410,423 donors. A total of 426,142 (69.2%) were from repeat (Rpt) donors and 189,237 (30.8%) were from first-time (FT) donors. Twenty percent of FT donors returned to donate in the period. FT donors were more likely to be younger, and Rpt donors were more likely to be community donors. All were predominantly male. Replacement donors still represent 50% of FT and 30% of Rpt donors. The mean percentage of the potentially general population who were donors was approximately 1.2% for the three centers (0.7, 1.5, and 3.1%). Adjusting for the catchment`s area, the first two were 2.1 and 1.6%. CONCLUSIONS: Donors in the three Brazilian centers tended to be younger with a higher proportion of males than in the general population. Donation rates were lower than desirable. There were substantial differences in sex, age, and community/replacement status by center. Studies on the safety, donation frequencies, and motivations of donors are in progress to orient efforts to enhance the availability of blood.

Molecular Epidemiology of Avian Infectious Bronchitis in Brazil from 2007 to 2008 in Breeders, Broilers, and Layers

Multiple lineages of Brazilian strains from 2007 to 2008 of avian infectious bronchitis virus (IBV) were detected in flocks of breeders, broilers, and layers. Organs samples from 20 IBV-positive flocks with variable clinical signs were submitted to the partial amplification of S gene (nucleotides 726-1071) of IBV. Fifteen of the 20 sequenced strains segregated in a unique Brazilian cluster subdivided in three subclusters (Brazil 01, 02, and 03). Whereas three strains could be classified as Massachusetts (Mass) genotype, the remaining two strains, originating from flocks with reproductive and respiratory disorders, grouped within the 4/91-793B genotype, a genotype that has not been detected before in Brazil. The potential relevance of the findings to the poultry industry is discussed because the low level of identity of the sequenced part of the S gene from 17 of 20 detected field strains and the vaccines of the Massachusetts serotype used suggest that the level of cross-protection by the Massachusetts vaccines might be low.

A????es premiadas no 13?? Concurso Inova????o na Gest??o P??blica Federal 2008

Nesta publica????o, referente ao 13?? Concurso Inova????o na Gest??o P??blica Federal, o leitor encontrar?? iniciativas inovadoras nas seguintes ??reas: Arranjos institucionais para coordena????o e/ou implementa????o de pol??ticas p??blicas; atendimento ao cidad??o; melhoria dos processos de trabalho; planejamento, gest??o e desempenho institucional

Relat??rio de gest??o 2008

A Escola Nacional de Administra????o P??blica - ENAP ratificou sua miss??o de desenvolver compet??ncias de servidores p??blicos para aumentar a capacidade de governo na gest??o das pol??ticas p??blicas, buscando o enfrentamento dos desafios previstos at?? 2010, quais sejam: consolidar-se como refer??ncia na forma????o de dirigentes; implementar de forma estrat??gica e inovadora a Pol??tica Nacional de Desenvolvimento de Pessoal - PNDP; prospectar e disseminar conceitos e tecnologias inovadoras de gest??o de pol??ticas p??blicas; prospectar, construir e disseminar, interna e externamente tecnologias educacionais inovadoras; tornar-se escola de governo refer??ncia nacional e internacional; e consolidar-se como uma organiza????o de aprendizagem. A relev??ncia da capacita????o ?? destacada pelo Decreto n?? 5.707/06, que criou a PNDP. Em 2008 a ENAP destacou-se no processo de implementa????o desta Pol??tica, por integrar seu Comit?? Gestor e coordenar o sistema de escolas de governo da Uni??o